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PDA 3 > Masamha Exam 3 Materials > Flashcards

Masamha Exam 3 Materials Flashcards

1
Q

anti-protozoals

What are some general considerations when using anti-protozoal drugs?

A
  • many not safe for use in pregnancy
  • considered toxic at therapeutic doses, so serious side effects may occur especially on cells with high metabolic rate
  • drug resistance
  • some drugs can only be obtained directly from the CDC
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2
Q

anti-protozoals

What is the amebiasis species that causes disease in humans?

A

Entamoeba histolytica

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3
Q

anti-protozoals

How are amebiasis transmitted?

A

oral-fecal route

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4
Q

anti-protozoals

How do amebiasis infect humans?

A
  1. an amebic cyst survives the gastic acid contents
  2. passes into lumen of intestine
  3. transforms into trophozoites which reside in the large intestine
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5
Q

anti-protozoals

What are the symptoms of an Entamoeba histolytic infection?

A
  • asymptomatic if in the intestinal lumen
  • servere diarrhea and abdominal cramps when trophozoites invade the intestinal lumen
  • amebic colitis and bloody diarrhea (AMEBIC DYSENTERY) when trophozoites ulcerate colonic mucosa
  • liver abscess when trophozoites infect portal vein
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6
Q

anti-protozoals

What is the treatment for asymptomatic intestinal lumen amebiasis infection?

A
  • paromomycin
  • iodoquinol
    eliminate cysts in bowel lumen, used in addition to other drugs to treat other forms of amebiasis
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7
Q

anti-protozoals

What is the contraindication to Iodoquinol?

A

reaction to iodine

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8
Q

anti-protozoals

What is the use of nitroimidazoles?

A

mild-moderate infection and invasive colitis (intestinal, extraintestinal, and tissue infection) and dysentry- kills trophozoites in bowel wall and liver

not effective at targeting cysts in bowel lumen

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9
Q

anti-protozoals

What drugs are nitroimidazoles?

A
  • metronidazole
  • tinidazole
  • nitazoxanide
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10
Q

anti-protozoals

What is the mechanism of action of metronidazole?

A

ferredoxin is reduced via PYRUVATE-FERREDOXIN OXIDOREDUCTASE (PFOR) enzyme which activates metronidazole = cytotoxic nitro free radical that can bind DNA and protein which inhibits DNA synthesis and induce DNA degradation= cell death

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11
Q

anti-protozoals

What is the mechanism of action of tinidazole?

A

creates cytotoxic free radicals and drug interactions

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12
Q

anti-protozoals

What is the mechanism of action of nitazoxanide?

A

differs from other nitroimidazoles, noncompetitive inhibition of pyruvate ferredoxin oxidoreductase (PFOR) which is essential for anaerobic energy metabolism

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13
Q

anti-protozoals

What is cryptosporidiosis?

A

waterborne disease caused by cryptosporidium spp. which presents with watery diarrhea (dehydration), cramps, N/V, fever

life threatening to immunocompromised pt

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14
Q

anti-protozoals

What is the treatment for Cryptosporidiosis?

A

nitazoxanide

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15
Q

anti-protozoals

What is Giardiasis?

A

intestinal parasite (giardia lamblia-a flagellate) which presents with diarrhea, abdominal cramps, greasy stools that float, dehydration, in severe cases: weight loss, malnutrition in kids due to failure to absorb fat

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16
Q

anti-protozoals

What is the treatment for giardiasis?

A

any nitroimidazole but metronidazole is 1st line

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17
Q

anti-protozoals

What is trichomoniasis?

A

STD, common cause of vaginitis and urethritis which presents with itching/irritation, dicomfort, and discharge

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18
Q

anti-protozoals

What is the treatment for trichomoniasis?

A

any nitroimidazole, but metronidazole is first line

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19
Q

anti-protozoals

How is toxoplasmosis transmitted?

A

foodborne- undercooked or contaminated meats and vegetables, animals (cats), and fetal transmission

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20
Q

anti-protozoals

What is the presentation of toxoplasmosis?

A

most healthy people are asymptomatic, but may cause mild flu like illness in healthy individuals
in immunocompromised and pregnant pts it can cause severe illness and miscarriage/stillbirth of unborn children

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21
Q

anti-protozoals

What is the treatment for toxoplasmosis?

A

pyrimethamine AND sulfadiazine (for synergistic effects) AND leucovorin calcium (due to induced folate deficiency from pyrimethamine)

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22
Q

anti-protozoals

What is the cause of african sleeping sickness?

A

tsetefly transmits Tb gambiense or Tb rhodesiense

23
Q

anti-protozoals

What is the use of pentamidine isethionate?

A

early stages of african sleeping sickness caused by Tb gambiense (no CNS involvement)

24
Q

anti-protozoals

What is the mechanism of action of Pentamidine isethionate?

A

targets and binds DNA in kinetoplase to inhibit replication and function

25
Q

anti-protozoals

What drugs treat african sleeping sickness?

A
  • pentamidine isethionate
  • suramin
  • eflornithine
  • melarsoprol
26
Q

anti-protozoals

What drug for the treatment of african sleeping sickness has a 4-6% death rate of users?

A

melarsoprol

for late stage with CNS involvement (high mortality)

27
Q

anti-protozoals

What is the indication of Suramin?

A

early stage african sleeping sickness

28
Q

anti-protozoals

What is the indication of eflornithine?

A

early or late (CNS involvement) african sleeping sickness

29
Q

anti-protozoals

What are adverse effects of suramin?

A

neurologic effects

30
Q

anti-protozoals

What are the adverse effects of eflornithine?

A

death (1%)

31
Q

anti-protozoals

What is the mechanism of action of melarsoprol?

A

inhibits pyruvate kinase= inhibits glycolysis= decrease ATP synthesis which is essential to the survival of the organism

32
Q

anti-protozoals

What is the cause of Chaga’s disease?

A

trypanosoma cruzi

33
Q

anti-protozoals

What is the treatment for chaga’s disease?

A
  1. benznidazole
  2. nifurtimox
34
Q

anti-protozoals

What are the monitoring parameters for patients on treatment for chaga’s disease?

A
  • blood count
  • hepatic function panel
  • CMP
35
Q

anti-protozoals

What is the mechanism of action of benznidazole?

A

inhibit protein and RNA synthesis

36
Q

anti-protozoals

What is the mechanism of action nifurtimox?

A

generates intracellular oxygen radicals

CDC only

37
Q

anti-helmintics

What is mazzotti reaction?

A

immunologic reaction (toxicity) due to dead and dying worms- can be life threatening

38
Q

anti-helmintics

What is the mechanism of action of praziquantel?

A

increase the cell wall permability to Ca2+ (increased cellular Ca2+)= paralysis of worm/detachment= expulsion

39
Q

anti-helmintics

What is the indication of praziquantel?

A
  • cestodes
  • trematodes
40
Q

anti-helmintics

What antihelmintics do not cause mazzotti reaction?

A
  • praziquantel
  • pyrantel pamoate
  • benzimidazoles
41
Q

anti-helmintics

What parasites is pyrantel pamoate the drug of choice for?

A
  • pinworms (enterobius vermicularis)
  • hookworms
42
Q

anti-helmintics

What is the mechanism of action of pyrantel pamoate?

A

nicotinic receptor agonist= paralysis= expulsion

43
Q

anti-helmintics

What drug can be used for mixed parasitic infections?

A

benzimidazoles (albendazole, mebendazole, not triclabendazole)

44
Q

anti-helmintics

What antihelmintic drugs are contraindicated in pregnancy?

A
  • benzimidazoles (albendazole, mebendazole, triclabenazole)
  • ivermectin (safety not estabilished)
45
Q

anti-helmintics

What is th mechanism of Ivermectin?

A

GABA agonist= Cl- influx= paralysis= death

mazzotti reaction

46
Q

anti-helmintics

What is the indication of ivermectin?

A

nematode infections including onchocerciasis (african river blindness)

47
Q

anti-helmintics

In what pt populations should ivermectin not be used?

A
  • pregnent pt
  • pt with meningitis
48
Q

anti-helmintics

What is the use of Diethylcarbamazine?

A

worms that effect the lymph nodes

CDC only

49
Q

anti-helmintics

What is the use of moxidectin?

A

onchocerciasis (african river blindness) that is resistant to ivermectin

50
Q

ectoparasites

What is the 1st line treatment option for lice/scabies?

A

permethrin

51
Q

ectoparasites

What is the use of pyrethrins?

A

lice only

52
Q

ectoparasites

What drug can only be used to treat scabies?

A

crotamiton

53
Q

ectoparasites

What is the treatment for head lice only?

A
  • spinosad
  • malathion
  • pyrethrins

PDA 3 (5 decks)

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